Dozens of U.S. state legislators have written a letter urging congressional Republicans to support an immediate extension of Affordable Care Act (ACA) subsidies, which are set to expire at the end of the year. The lawmakers warn that allowing the subsidies to lapse would lead to significant negative consequences for their constituents, particularly as health insurance premiums are projected to rise sharply.
The letter, obtained by Common Dreams ahead of its official release, was sent just days before open enrollment for the ACA begins in most states on November 1. According to a recent analysis by the Kaiser Family Foundation (KFF), health insurers are increasing premiums by an average of 26% for the upcoming year. Many enrollees could face even higher costs if the ACA subsidies, which are central to the ongoing federal government shutdown, are not extended.
The legislators, representing millions of residents from states such as Maine, Georgia, and Michigan, argue that Republicans in Congress are responsible for creating a “manufactured healthcare crisis,” especially for younger Americans. They note that many young people are entering the workforce, working in the gig economy, or starting small businesses, and may need to purchase coverage through ACA exchanges. Forcing them to go without insurance or pay excessive premiums could result in long-term financial burdens, including medical debt that could hinder their ability to save, buy homes, or participate fully in the economy.
Among the 41 signatories of the letter, organized by the advocacy group Defend America Action, are Maine House Speaker Ryan Fecteau and Michigan Senate President Pro Tempore Jeremy Moss. The letter is addressed to House Speaker Mike Johnson and Senate Majority Leader John Thune.
“Republicans’ decision to prioritize billionaires’ tax breaks over the health and financial well-being of the American people is both cruel and calculated,” the lawmakers wrote.
Without the enhanced ACA tax credits, many younger individuals—typically healthier—may choose to drop coverage, potentially triggering a “death spiral” of rising premiums across the board. The Congressional Budget Office has estimated that more than 4.2 million people could lose their health insurance if the subsidies expire.
“Let us be clear: This is a conscious choice to strip healthcare from the American people,” the legislators stated. “Allowing these credits to expire will undo progress and plunge Americans into financial instability and uncertainty. It is a cruel and calculated decision that puts billionaires’ interests above the health and well-being of the people you serve.”
The lawmakers emphasized that the solution is simple and urgent. “You must immediately pass a clean extension of the enhanced ACA tax credits before open enrollment begins on November 1, after which it will be too late. The health of millions is at stake.”
This demand adds to the growing pressure on Republican lawmakers, who are facing mounting concerns from constituents as they refuse to negotiate with Democrats on extending the subsidies as part of any deal to end the government shutdown.
According to the Associated Press, frustration among voters is increasing, with town halls filled with concerned citizens. Recent polling shows widespread concern about premium hikes among likely voters across party lines.
Sen. Patty Murray (D-Wash.) criticized Republican leaders for not addressing the issue. “It is painfully clear that Republicans are not listening to folks back at home,” she said. “Families are asking, ‘Please stop my premiums from doubling,’ but Republican leaders are saying, ‘Not our problem—we never wanted to lower healthcare costs in the first place.'”
In addition to the health implications, the expiration of ACA subsidies could have serious economic consequences. A recent analysis by the Commonwealth Fund estimated that nearly 340,000 jobs could be lost nationwide next year if the subsidies lapse. Georgia, one of the states represented in the letter, could see 33,600 job losses in 2026, second only to Texas and Florida.
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